健康状态负效用值测量结果合并方法及影响因素研究——以抗肿瘤药所致腹泻为例
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篇名: 健康状态负效用值测量结果合并方法及影响因素研究——以抗肿瘤药所致腹泻为例
TITLE: Research on merging methods and influencing factors of health state disutility values estimation :taking diarrhea caused by antitumor drugs as an example
摘要: 目的 探究健康状态负效用值测量结果的合并方法和影响因素。方法计算机检索中国知网和PubMed等6个中英文数据库,系统检索国内外抗肿瘤药致腹泻的负效用值测量文献,检索时限均为各数据库建库起至2021年7月。由2名研究者独立筛选文献、提取资料并评价质量后,应用Stata16.0进行Meta分析和回归分析。结果共纳入15篇文献。Meta分析结果显示,抗肿瘤药所致腹泻对健康效用的影响有统计学意义[MD=-0.26,95%CI(-0.30,-0.22),P<0.05]。亚组分析结果显示,负值类、非负值转负值类、合并基础状态的非负值转负值类数据的合并结果分别为MD=-0.14、95%CI(-0.19,-0.09),MD=-0.46、95%CI(-0.56,-0.36),MD=-0.12、95%CI(-0.20,-0.05)。Meta回归结果显示,发表年份、调查国家/地区、不良事件等级、基础状态设定、效用测量工具、效用报告类型及效用统计方法对腹泻负效用值测量结果的影响均有统计学意义(P<0.05)。结论在输入经济性评价模型参数时,学者应充分考虑治疗相关症状或并发症的负效用值;在进行负效用值研究或应用时,应区分效用报告类型,并重点关注调查国家或地区、患者症状或并发症的严重程度、基础状态是否设定等核心影响因素。
ABSTRACT: OBJECTIVE To explore the merging methods and influencing factors of health state disutility values estimation. METHODS Retrieved from 6 Chinese and English databases such as CNKI and PubMed ,the literatures about disutility values of diarrhea caused by antitumor drugs were collected from the inception to July 2021. After 2 researchers independently screened the literature,extracted the data ,assessed the quality ,the Meta-analysis and regression analysis were conducted using Stata 16.0 software. RESULTS Fifteen literatures were included. The results of Meta-analysis showed that diarrhea caused by antitumor drugs had a significant impact on health utility [ MD=-0.26,95%CI(-0.30,-0.22),P<0.05]. The results of subgroup analysis showed that the disutility values of the 3 types of negative value ,non-negative value changed into negative value ,and non-negative value combined with basic state changed into to negative value were MD =-0.14,95%CI(-0.19,-0.09);MD=-0.46,95%CI (-0.56,-0.36);MD=-0.12,95%CI(-0.20,-0.05),respectively. Meta regression results showed that the year of publication , survey country/region ,severity of adverse events ,basic state settings ,utility estimation tools ,utility report types ,and utility statistical methods significantly affected the value of diarrhea disutility (P<0.05). CONCLUSIONS Disutility values for treatment-related symptoms or complications should be fully considered when inputting the parameters to the economic evaluation model. In the study or application of disutility values ,the types of utility reports should be distiguished ,and the core influencing factors such as the investigation country or region ,the severity of symptoms or complications ,and whether the basic state is set should be focus on.
期刊: 2022年第33卷第08期
作者: 卢钰琼,代展菁,路云,常峰
AUTHORS: LU Yuqiong ,DAI Zhanjing ,LU Yun,CHANG Feng
关键字: 负效用值;健康状态效用值;抗肿瘤药致腹泻;影响因素;Meta分析;药物经济学评价
KEYWORDS: disutility value ;health state utility values ;diarrhea caused by antitumor drugs ;influencing factors ;Meta-analysis;
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